How to Select a Fertility Clinic

by Joshua Shoemake

Jan 01, 2015

If you have been trying to get pregnant for 1-2 years without success, you may decide it’s time to take things to the next level in your baby making journey. Fertility clinics can help by assessing your medical and sexual history, identify potential causes of infertility, and recommend treatment. That may seem like a big step to take, so it is wise to do a little research into where to go. What factors should you consider when you select a fertility clinic?

What Criteria Makes a Fertility Clinic “Good”?

Not all fertility clinics are the same and there is certainly a range of quality in the services. Published success rates are only one of many factors to consider. Here are other points to think about when you’re making your decision:

Clinic Environment. Is it a calm, welcoming place, or do you feel like you’ve stepped into a tornado with lots of noise and chaos all around, or worse, like nobody even knows you’re there? Every business has “off” days, so while chaos can’t always be avoided, it should be infrequent and properly taken care of. Fertility treatment can feel like a bumpy ride at the best of times, but you need to feel confident that you are being looked after and respected.

Range of Services. Does it offer less-invasive treatment options and tailor treatment to the couple, or do its patients always move straight into IVF or ICSI? Does the clinic offer IVF and ICSI, or does everyone automatically have ICSI? Ideally, the treatment choice should be based on maximizing a couple’s chance of having a healthy baby, and so should offer the couple some input in creating their own personalized treatment plan.

Attention to Both Partners. It is a good sign when a clinic respects that this is a journey the couple would have preferred to make together (and on their own). That is shown by taking care of the men just as well as the women. For example, does the clinic offer a comfortable, private space for men to collect their semen samples? Do they offer visual and physical aids to collection (like Pre-Seed)?

Collaboration. If you’re interested in complementary, or “alternative”, healthcare options (like acupuncture, massage, visualization, etc), is the clinic willing to work with your alternative health care provider? If not, are they able to explain why? Again, it’s about you being comfortable with your choices, including whether or not you decide to go ahead with complementary healthcare.

Teamwork. Fertility treatment isn’t just about the doctor – there is an entire team that contributes to the clinic’s quality and success. Have you met members of the team (nurses, embryologists, counselors, etc)? Is their existence acknowledged? Are they all competent in their roles (are they accredited? Is the clinic itself accredited?)?

How they define success. What is your chance of having a healthy baby? This is the big question, since that’s the point of the whole journey. But how do you figure out the answer? Most clinics publish their own “pregnancy rates” on their website, but they don’t all refer to the same thing. Some points to look for:

What does “pregnancy” mean – a positive on a pregnancy test kit or evidence of a growing fetus (by ultrasound)? The chance of losing a pregnancy between the first positive test and the ultrasound can be even higher than 20%, so the definition of pregnancy that the clinic uses can make a big difference to how you interpret their results.

How many embryos are needed for a transfer to achieve each pregnancy, and how many pregnancies are multiple pregnancies (twins and more)? With IVF or ICSI treatment, there will usually be more than one embryo. Since, statistically, each embryo has a defined chance of implanting and establishing a pregnancy, then transferring more than one embryo at a time increases the overall chance of pregnancy. But this also creates the risk that multiple embryos will implant.

The first thought that people usually have is “great – an instant family!” – but this isn’t necessarily a good thing, as the health risks to the mother and to the babies are far higher with a multiple pregnancy. Since the aim is to fulfil your dream of having a healthy baby, the safer option is to have fewer embryos transferred at a time, with the aim of one baby per pregnancy.

A good indicator of a good clinic is that they are able to transfer fewer embryos per patient, but are still able to maintain good pregnancy rates.

Are the website’s published pregnancy rates from a short time period or do they report the results from over a year or more? Being able to maintain pregnancy results over a longer time shows that the clinic has good control over its systems. Reporting results from a short, higher-than-average, time period manipulates the rates in their favor.

Are the pregnancy rates on the website similar to those that the clinic reported to SART, or regulators (like HFEA in the UK)? Ideally, they should be.

Overall, a fertility journey can be a bumpy ride. In choosing the clinic that is right for you it is important that you feel comfortable and confident that, whatever the outcome, you made the right decision and there is no need to second guess.